NPI: 1710950605 · KENMORE, NY 14217 · Public Health Dentist · NPI assigned 02/10/2006
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 329 | $13K |
| 2019 | 134 | $5K |
| 2020 | 238 | $9K |
| 2021 | 350 | $13K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1110 | Prophylaxis - adult | 435 | 434 | $23K |
| D0120 | Periodic oral evaluation - established patient | 417 | 416 | $11K |
| D0274 | Bitewings - four radiographic images | 152 | 151 | $4K |
| D0330 | Panoramic radiographic image | 34 | 34 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 13 | 13 | $366.45 |